Healthcare Provider Details

I. General information

NPI: 1932431129
Provider Name (Legal Business Name): NEUROLOGICAL CARE CENTER OF LIMA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W HIGH ST SUITE 260
LIMA OH
45801-3971
US

IV. Provider business mailing address

830 W HIGH ST SUITE 260
LIMA OH
45801-3971
US

V. Phone/Fax

Practice location:
  • Phone: 419-979-3212
  • Fax:
Mailing address:
  • Phone: 419-979-3212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35091015
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. AHMAD A ANOUTI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 419-979-3212